POLITICO-Harvard poll: Democrats and Republicans still fixated on health care

With taxes and spending, debt and defense piled up on Congress’ extremely full plate this month, a new poll by POLITICO and the Harvard T.H. Chan School of Public Health shows that Americans remain sharply focused on health care — but Republicans and Democrats aren’t looking at the same things.

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Republicans say their top priority is making another attempt at getting the Affordable Care Act, or Obamacare, repealed and replaced.

Democrats say theirs is getting the Children’s Health Insurance Program funded. Congress missed a Sept. 30 deadline to renew federal funding, and now coverage for 9 million low-income kids is enmeshed with all the other year-end spending fights.

Given a list of 15 policy issues pending in Congress, Republicans put Obamacare repeal on top. Forty percent called repeal an “extremely important priority” and 33 percent said “fixing the current problems” in the health care law was a top concern. Obamacare beat out other top priorities for Republicans, which included halting unauthorized immigration (38 percent), cutting taxes (35 percent), and boosting national defense spending (34 percent).

The unrelenting emphasis on Obamacare — when so many other issues float on and off the public'sradar — suggests it’s truly a defining, gut issue for the GOP.

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“Among Republicans, I think it’s a Hatfield and McCoy issue,” said Harvard's Robert Blendon, an expert on health care and politics, referring to the legendary 19th century family feud.

The fact that Republicans are “checking both boxes” —repeal the health law or fix it — suggests “they want to feel they got something different out of this debate … although I don’t think we can get them to agree on what that is,” added Blendon, who co-designed the poll with POLITICO.

Barely on the radar for Republicans is renewing the protections for DREAMers — the undocumented immigrants brought to the United States as children (5 percent) — and investigating Russia’s role in the 2016 elections (4 percent). Trade, a hot issue over the past year for Trump voters, has also dropped off.

Democrats’ emphasis on the children’s health program may come as a surprise because CHIP hasn’t received a lot of attention from politicians or the media. That’s partly because states and the Trump administration have so far been able to cobble together short-term solutions to stave off a crisis, although it’s getting harder each week. And most people in Washington still think Congress will fix the popular program somehow.

“If you watch the news it’s not about children's health, so the priority there is quite extraordinary,” Blendon said.

After CHIP, which 48 percent of Democrats identified as a top priority, they also listed stricter gun laws (47 percent), giving more hurricane recovery help to Puerto Rico (43 percent), lowering prescription drug prices (39 percent), and investigating Russia’s role in the election (35 percent). The lowest priorities for Democrats were Obamacare repeal, boosting defense spending and allowing more drilling in the Arctic National Wildlife Refuge in Alaska, all of which were ranked a top priority by just 5 percent of respondents.

The poll did not ask whether people who support Obamacare repeal would be satisfied by killing the law's individual mandate in the GOP tax bill, which currently seems likely. But scrapping that highly unpopular provision will give Republican lawmakers an anti-Obamacare achievement to take home to their voters.

On taxes, just under half of Republicans (49 percent) backed Congress’ tax overhaul. A similar proportion thought they themselves would benefit — 1 in 4 thought it would help them “a lot” and another quarter thought they’d get “a little” help. A paltry 4 percent of Democrats gave it their blessing.

On health, about half of Republicans and Democrats expect their insurance premiums to go up, and just under half expect them to stay the same. Of those expecting a spike, 37 percent of Republicans blamed insurers (versus 23 percent of Democrats) and 13 percent blamed doctors and hospitals (versus 8 percent of Democrats).

Not surprisingly, 45 percent of Democrats said higher premiums would be the fault of President Donald Trump and the Republicans — and just over a third of the Republicans blamed the Democrats.

The poll also looked at how Americans view the opioid crisis, which Trump declared a national public health emergency in October without requesting more resources for the problem. More than half of those surveyed considered it a major problem but not a “national emergency.”

Indeed, many of those polled regarded opioids as a state and local problem — not one for Washington to solve. That means that despite the clamor in Washington and in the public health world about Trump not requesting more funds, the public isn’t really looking to Trump for solutions, Blendon said.

The public also split on whether the government should mandate health plans to treat opioid abuse — with 48 percent supporting the requirement and 49 percent opposing it. Democrats were far more likely to favor it.

The survey was conducted by SSRS, an independent research company, for POLITICO and Harvard from Nov. 15-19. It used cellphones and landlines among a nationally representative sample of 1,009 U.S. adults.